重组bFGF-PLA胶状复合体骨创面止血的实验研究

Study on hemostasis of bone wound with rbFGF-PLA colloidal complex in vivo

目的探讨重组bFGF(碱性成纤维细胞生长因子)-PLA(聚乳酸)胶状复合体对兔髂骨创面的止血效果及降解后骨修复作用。方法将清洁级日本大耳白兔15只(复制60个骨创面)分为重组bFGF-PLA胶状复合体组(A组,30个骨创面)、骨蜡组(B组,15个骨创面)、空白对照组(C组,15个骨创面)。于钻孔后1、10 min观察、记录骨创面出血情况。术后4、8、12周分别随机抽取5只动物,再次显露术区,观察并记录各组骨创面愈合情况并将实验区髂骨标本HE染色后观察。结果钻孔后1、10 min观察均可见A、B组止血效果显著,C组无效,B组骨创面止血效果与A组比较,无统计学差异(P>0.05),与C组比较,A、B组止血效果均明显(P<0.05)。术后12周镜下可见,A组缺损区完全由新生骨替代,成骨细胞减少,骨小梁更趋成熟,部分创面可见破骨细胞增生,创面孔洞修复。B组创面边缘骨小梁萎缩,有较多炎性细胞存在,缺损区未见任何组织长入。C组创缘可见成骨细胞增生,新生骨组织填充创面基底,缺损区可见纤维瘢痕组织生长,覆盖创面。结论重组bFGF-PLA胶状复合体既能起到与骨蜡相似的止血效果,又可降解吸收同时利于骨创面修复。

Objective To investigate the effect on hemostasis of bone wound with recombinant basic fibroblast growth factor-poly- lactic acid （rbFGF-PLA） colloidal complex and its bone repair after degradation. Methods Fifteen clean level Japanese big ear rabbits were divided into three groups： rbFGF-PLA colloidal complex group （Group A, 30 bone wound surfaces） , bone wax group （Group B, 15 bone wound surfaces） and blank control group （Group C, 15 bone wound surfaces）. Bone wound bleeding was ob- served and recorded at the time point of 1-and lO-min after the borehole was performed. Five animals were chosen at 4, 8 and 12 weeks after operation at random, and were shown the operated area again. We observed and recorded each bone wound healing of experimental area and the iliac specimens were observed after HE staining. Results Hemostatic effect was remarkable in Group A and Group B and invalid in Group C at the time point of 1-and 10-min. There was no significant difference in the effect of hemosta- sis between Group A and Group B （ P 〉 0.05 ） , but compared with group C, either of Group A or B was of significance in the effect of hemostasis （P 〈0.05）. We saw under microscope at 12 week postoperatively that the defect areas of Group A were entirely sub- stituted with new bone. In Group A, osteoblasts reduced, trabecular bone matured, osteoclast hyperplasia was visible in some wounds and the hole of bone wound was repaired. In Group B, the trabecular bone atrophy on the edge of the wound was observed. There were a number of inflammatory cells, and no tissue grew in the defect area. Osteoblast proliferation and new bone tissue filling wound basement were observed at the edge of wound in Group C. Fibrous scar tissue was observed and covered the wound in the defect area. Conclusion The hemostatic effect of rbFGF-PLA with colloidal complex on bone wound is similar with bone wax. Also, it has the characteristic of biodegradable absorption and is good for bone wound rephir.